While gestating, I suffered a constellation of symptoms in several body systems. My legs ached and vibrated with pain. I developed hives—angry welts that refused to yield to hydrocortisone. My skin grew hypersensitive, and I flinched at my husband’s gentlest touch. I fell into a black, clinical depression. I developed obsessive-compulsive disorder, shrinking from any smudge on the wall. Morning sickness consumed me all day; it did not dissipate after the first trimester, as it does for most women.

I also had a little-known condition called irritable uterus, which causes a severe tightening of the uterine and abdominal muscles early in pregnancy. By eight weeks, I could not stand up without feeling like a boa constrictor had wrapped itself around me, squeezing tightly. I was frequently bedridden, unable to exercise, work, or even walk far enough to leave my apartment. Then, at 32 weeks, I became plagued with urinary tract infections that lasted the remainder of my pregnancy.

This spiderweb of complications created what I dubbed a ”prisoner pregnancy.” Despite wanting the pregnancy to result in motherhood, I did not feel any joy in gestation. I counted the days, trying to reassure myself that all pregnancies eventually come to an end.

My daughter is now five years old; she is also the love of my life. But my husband and I have been careful to make sure that I never get pregnant again. It’s not only that I grew so ill from it. We are also happy to have one child, and we know the full measure of our resources—financial, emotional, and otherwise. We are not surrounded by family, nor do we have the budget for much help with childcare, and I want to go back to work.

My period went missing a few days into the new year.

One cold January night, I woke up with throbbing joints. Days later, a rash spread across my ankles. The symptoms felt frighteningly familiar, so I took a pregnancy test, but the result was—unsurprisingly—negative.

There hadn’t been much time for intimacy in recent months. I had undergone several aggressive surgeries that had depleted my reserves. I'd had reconstructive surgeries on my hips, and I’d also lost a rib to a fast-growing tumor. Calamity struck again when the mesh scaffolding that had replaced my rib snapped in two and I had to head back to the operating room for a second emergency chest-wall repair just six days before Christmas.

By February 1, my period still had not returned. My aches and chills had grown persistent, and nausea had descended. I assumed the symptoms—so like those of my last pregnancy—were aggravated premenstrual syndrome. I hoped a gynecologist could induce my period and get me back to normal. Six days later, I found myself handing a urine sample to a nurse and waiting gratefully for my doctor to arrive in the exam room. Help was on the way.

Dr. Park* walked in.

“You’re pregnant,” she said, smiling at me.

I shifted on the table, the crinkle of the paper resonating in my ears as my adrenaline surged.

Truly, I could not remember a moment when my husband and I had been together long enough to conceive a pregnancy. I remembered hazy moments of closeness, of struggling to connect across the vast distance created by my bodily trauma and pain, but I do not recall sex. I would soon find out that such was my husband’s exhaustion that he didn’t remember such a moment either.

After years of vigilance, we’d been caught in nature’s snare. We were tired, we were stressed, and we’d accidentally conceived.

A sonogram revealed that I was just six weeks pregnant. The tears that I’d fought off through multiple surgeries at last came. Once again, pregnancy was my undoing. I walked home, my tears mingling with a sudden and fittingly unexpected rainstorm.

That afternoon, I spoke to my husband. We held each other tight and discovered, with great relief, that we were of one mind: We did not want this pregnancy.

I called Dr. Park’s office again and again, begging to speak to her as soon as possible, letting her nurse know that I needed a termination right away. The nurse told me to be patient and that someone would get back to me.

The next two days crawled by, as my symptoms accelerated.

Clumps of hair fell out. Hives spread up my thighs. I vomited repeatedly, gagging when there was nothing left to throw up. The bell-like sweetness of my kindergartner’s chatter seemed distant and hollow; depression was descending and distorting my world.

I was once again locked in a prisoner pregnancy.

Finally, three days after I’d left those urgent messages, a colleague of Dr. Park’s called and told me to come in.

Dr. Roberts* had an easy way about her. She smiled a lot, and her thick ponytail swung as she checked her notes and looked up to chat with me. She asked if I wanted to perform another sonogram to see if the pregnancy was still viable. I asked her why I would want to do that if I already knew I wanted to abort.

“I just thought you might want Dr. Park to do it, since you know her better, and if there’s been a drop in hormones…if there’s evidence the embryo is no longer viable, she can do it.”

“Why can’t she do it anyway?” I asked, pulling my aching legs into my chest.

Dr. Park, Dr. Roberts explained, did not perform “elective” abortions—only “therapeutic” ones. If the embryo was no longer viable or if my health was at grave risk, Dr. Park would be willing to perform a D&C (dilation and curettage procedure). As it stood, my abortion was a personal choice; this was why Dr. Park had vanished from the scene of my health care. I wondered why she hadn’t told me herself.

Dr. Roberts leaned in and spoke with authority and humor.

“I would guess more women in Manhattan have D&Cs than have tooth cleanings in a year. And they are certainly less painful.” She smiled. “It sounds like you know what you want. You feel sick, you are happy with one child, you don’t have the resources. You’ve outlined your understanding of your life quite clearly,” she finished. She was working hard to reassure me, sensing that Dr. Park’s rebuff had stunned me. She was right: I felt suddenly judged and humiliated.

Later that night, I found myself trying to decipher the terms “elective” and “therapeutic,” searching the Internet for definitions.

“An elective abortion is one initiated by personal choice. Roughly 20 percent of all pregnancies (excluding miscarriages) end in elective abortion.” —The New York Times

“A therapeutic abortion is one induced for the sake of the mother’s physical or mental health or to prevent the birth of a congenitally compromised child.” —Medilexicon

These are but two of the dozens of definitions of “elective” and “therapeutic” abortions that crop up in a Google search. They are not legal terms. They are not even medical ones. The distinction Dr. Park made in providing care implied to me a moral judgment.

Therapeutic: deserving of medical care.

Elective: undeserving of medical care.

The judgment began to pervade my mind.

I called a pro-choice friend to tell her about my crisis.

She replied, “You are the reason abortion should be legal.” I was stunned. Did she think that if a woman felt perfectly healthy during pregnancy, she should be obligated to carry it, regardless of whether or not she wanted a child? When I mentioned my situation to mothers at my child’s school, they told me I should wait a few more weeks. One woman even asked me if my husband had exerted pressure on me to have an abortion. Every woman I spoke to had proudly walked in the Women’s March. Many had held “My Body, My Choice!” signs. But I had discovered a lurking hypocrisy in the pro-choice world.

Many people are pro-choice in theory, but they are not truly comfortable with the idea of terminating a pregnancy unless it threatens a woman’s life.

In the absence of genuine peril, a woman’s desire to terminate is—even to many self-described pro-choice people—problematic, unnatural, suspect. Lacking the social support I’d expected, I sank into despondency. I began to wonder if I was a weak person, unfit to cope with the normal travails of life. I would not die from this pregnancy, after all, and that was what Dr. Park cared about. It also seemed to be the only thing that concerned the women who’d denied me endorsement. I was merely electing to feel better, electing to care for my body, electing to decide my own fate. Perhaps that was not good enough.

When friends and acquaintances resisted my decision to have an abortion, I used my body’s pathological response to pregnancy as justification. I wanted to fit myself into the “therapeutic” category. I didn’t realize that I was already in it, because any woman who wants an abortion also needs one. She does not have to make a case for it; her desire is the case, and it is airtight. Women should not have to bargain for freedom by pleading physical distress. If we desire an end to a pregnancy, we have a right to define that pregnancy as an ailment and termination as its cure.

I cried on the way to my termination, not for myself but for the women who live in states where access is increasingly, maliciously blocked.

I was lucky to have insurance and access to excellent health care. I was lucky to be in New York City, where abortion rights are aggressively protected. Experiencing the horror of my pregnancy within the horror of denied access was beyond imaginable. Yet for many women, this is becoming the new normal, as states limit women's access to abortion services.

Even in New York City, I had been denied health care by one gynecologist, and I wondered how many others might be doing the same.

The D&C took 10 minutes. I awoke in recovery. The sun had burst through the gray clouds in my mind, and my mental floorboards were sparkling. The termination provided an immediate emotional lift: Gone was the fearsome melancholy. I was myself again.

I gazed through the hospital window at the crisp winter light glinting off the icy snow, a realization dawning: The terms “elective” and “therapeutic” were interchangeable. I had needed an abortion because I had wanted one. In the absence of hives or aches or depression or irritable uterus or nausea, my abortion would have been every bit as legitimate and my request for one no less urgent.

I will never visit Dr. Park again. Doctors who discriminate between elective and therapeutic abortions are violently bifurcating women, slicing them at the intersection of body and mind. If a woman does not want to be pregnant—for any reason—abortion is automatically a medical need. By granting dispensations only to women whose lives are imperiled by pregnancy and telling the rest of us that what we want is wrong, they chip away at a crumbling firewall we need ever more urgently in the fight for women's freedoms in this country.